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A Case of Teratoma of Thyroid Gland in Adolescence
이유창,정수진,이솔재,김종화,이용훈,이정은,서혜지 대한갑상선학회 2017 International Journal of Thyroidology Vol.10 No.1
Benign teratomas of the thyroid are very rare in adolescence and adults. In this review, we report a case of 14-year-old Korean girl with huge neck mass. She presented with anterior neck enlargement and compression symptom which was rapidly aggravated in 2 months. In physical examination, enlarged and firm right thyroid lobe was palpated and laboratory test of thyroid function was normal. In ultrasonography, right lobe was mainly occupied with a solid nodule size of 44×23×25 mm, showing markedly inhomogeneous hypoechogenicity. As fine needle aspiration cytology was non-diagnostic, lobectomy was done. Histological examination demonstrated that the tumor is benign thyroid teratoma composed of tissue from all three germ layers. When large thyroid nodule is detected in adolescence and malignancy could not be ruled out, final diagnosis should be made with surgical resection. And we should at least attentive for possibility of teratomas when ultrasonographic findings are suspicious.
이솔재,정수진,이유창,이용훈,이정은,김종화,민경완,차봉연 대한당뇨병학회 2017 Diabetes and Metabolism Journal Vol.41 No.4
Background: Diabetic cardiac autonomic neuropathy (CAN) is one of the important complications of diabetes. It is characterized by reduced heart rate variability (HRV). Methods: In this randomized, double-blind, placebo-controlled, multicenter trial, 75 patients were randomly assigned to one of two groups. One group (n=41) received α-lipoic acid (ALA) at an oral dose of 600 mg/day for the first 12 weeks and then 1,200 mg/day for the next 12 weeks. The other group (n=34) received placebo treatment for 24 weeks. CAN was assessed by measuring HRVs in people with diabetes. Results: Most of the baseline measures for HRVs were similar between the ALA and placebo groups. Although there were no statistically significant HRV changes in the ALA group compared to the placebo group after 24 weeks of trial, we found a positive tendency in some of the HRV parameters of the ALA group. The standard deviations of normal-to-normal RR intervals in the standing position increased by 1.87 ms in the ALA group but decreased by –3.97 ms in the placebo group (P=0.06). The power spectrum of the low frequency (LF) band in the standing position increased by 15.77 ms2 in the ALA group, whereas it declined by –15.04 ms2 in the placebo group (P=0.08). The high frequency/LF ratio in the upright position increased by 0.35 in the ALA group, whereas it declined by –0.42 in the placebo group (P=0.06). There were no differences between the two groups regarding rates of adverse events. Conclusion: Although a slight improvement tendency was seen in HRV in the ALA group, there were no statistically significant HRV changes in the ALA group compared to the placebo group after 24 weeks of trial. However, the high oral dose of ALA was well-tolerated.
Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus
조현아,Young Lee Jung,이용훈,이유창,Jung Eun Lee,이솔재,정수진,김종화 대한비만학회 2017 The Korean journal of obesity Vol.26 No.2
Background: Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia and body weight by inhibiting renal glucose reabsorption. However, only a few studies have demonstrated efficacy of dapagliflozin for type 2 diabetic patients in Korea. We evaluated the efficacy and safety of dapagliflozin for Korean type 2 diabetes patients. Methods: This is a retrospective study that included data from 61 patients who received 12 months of dapagliflozin therapy and who visited a single medical center between January 2015 and July 2016. Patients were separated into three groups: dual combination of dapagliflozin and metformin, triple combination of dapagliflozin and metformin with sulfonylurea, or dipeptidyl peptidase IV inhibitors, and quadriple combination of dapagliflozin, metformin, and sulfonylurea with dipeptidyl peptidase IV inhibitors. Patients who achieved ≥5% body weight reduction were classified as responders, and those who achieved <5% body weight reduction were classified as non-responders. Results: After 12 months, the mean change from baseline body weight was -3.4±2.6 kg (P<0.001) for all patients, -3.4±3.1 kg (P<0.001) for group 1, -2.7±2.0 kg (P=0.008) for group 2, and -4.0±2.3 kg (P<0.001) for group 3. Fasting C-peptide level was higher in the responder group than in the non-responder group (3.25±1.07 ng/mL vs. 2.62±1.02 ng/mL, P=0.023). In total, reductions in HbA1c, PP2, and FPG levels were -0.61±0.82% (P=0.000), -35.4±62 mg/dL (P=0.000), and -21.3±56.2 mg/dL (P=0.012), respectively. They had mild adverse events included orthostatic dizziness and urinary tract infection. Conclusion: SGLT2 inhibitor improved glycemic control and reduced body weight in a safe manner for patients with type 2 diabetes mellitus.
급성 대동맥 박리로 내원한 환자에서 발견된 갈색세포종의 1예
이솔재 ( Sol-jae Lee ),장호준 ( Ho-jun Jang ),이용훈 ( Yong-hoon Lee ),이정은 ( Jung-eun Lee ),이유창 ( Yu-chang Lee ) 대한내과학회 2017 대한내과학회지 Vol.92 No.3
본 증례에서는 급성 대동맥 박리에 대한 스텐트 시술을 시행한 이후 갈색세포종이 발견되어 수술적 치료를 진행하였고, 그 결과 혈역학적 안정이 확보됨과 함께 증상이 회복 되었다. 갈색세포종과 대동맥 박리가 동반되는 경우는 드물어 진단이 어렵고 치료 지침도 정립되어 있지 않은 실정이다. 따라서 대동맥 박리 환자에서 갈색세포종을 배제하기 위한 적극적인 노력이 필요하다 판단된다. Pheochromocytomas are neoplasms of the adrenal gland that are derived from chromaffin cells. One of the most important features of this tumor is that it can synthesize and release catecholamines such as norepinephrine and epinephrine. Due to this, arterial hypertension is one of the most common manifestations of the tumor. Although arterial hypertension is a substantial risk factor for aortic dissection, aortic dissection is actually a rare manifestation of pheochromocytoma. Here, we report a patient with pheochromocytoma who presented with acute type B aortic dissection. (Korean J Med 2017;92:286-290)